FILL IN THE BLANK – NAIC Executive Committee votes on the MLR blank (a.k.a. filing form) at this morning’s 8 a.m. meeting in Seattle. The vote is not the last word on how federal taxes factor into the calculation: an NAIC source cautions that there could well be further revisions to whatever instructions are approved today as a separate subgroup continues work on MLR methodology (they’re aiming to finish by the summer’s end).

Multiple commissioners say that, while surprises are possible, they’re confident the MLR blank should survive relatively unscathed. That does not mean we’re in for an entirely dull morning: watch for heated discussion on contentious points in MLR calculation, like whether ICD-10 compliance expenses should count as quality improvement (AHIP says yes) or if utilization review ought to be excluded altogether (hospitals pushed for this). The proposed blank: http://bit.ly/ao2H1t . Follow @sarahkliff for live tweeting of the meeting.

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UNITED HEALTH LOGS TAX OPINION - Alston & Bird, writing for client United Healthcare, says it doesn’t think the Democratic chairmen’s letter on federal taxes will stand up. “Such an interpretation would be contrary to the plain meaning of the statute,” the firm wrote in a letter to Sebelius and the NAIC’s Jane Cline. The letter: http://politi.co/bzw2Y7

Good Tuesday morning. As the final day of NAIC meetings wraps up, Sarah would like to thank the PPs (Pulse Parentals) for their hospitality (and the occasional free meal) during her stint back in Seattle.

“Oh the shark has pretty teeth dear, and he shows them Pulse white.” (h/t: P.A.)

PULSE SCOOP: BURGESS GETS ROI RESPONSE, HHS SAYS WORK STARTED MARCH 21 - HHS responded Aug. 3 to a Resolution of Inquiry request from Rep. Michael Burgess, who wanted internal HHS documents to determine if Chief Actuary Rick Foster’s cost estimates were withheld from Congress. HHS responded with an Aug. 2 memo from Foster to CMS Administrator Berwick, which said the actuaries weren’t able to start their cost estimates until after the House and Senate votes. Burgess tells PULSE that he appreciates the response, “but boy, it shouldn’t have taken an act of Congress to get that information.” He requested the info in a letter on June 14 before filing the ROI in late July. Burgess says the slow response makes him worried about the administration’s response on future oversight requests, but that he’s prepared to file additional ROIs when necessary. The response: http://politi.co/937qC1

FIRST READ: BROKERS SCORE IN SEATTLE - Thirteen states will sponsor a resolution affirming the “indispensible role that licensed insurance professionals play” at the NAIC Executive Committee meeting today, according to a draft obtained by PULSE. The resolution will specify that Exchange Navigators, a reform-created designation for individuals who help consumers obtain coverage via the Exchange, should stay out of licensed brokers’ territory, “limited to directing consumers to government agencies and licensed insurance professionals.” The resolution comes on the heels of a similar health committee amendment Monday. It signals that NAIC will watch out for brokers, who have worried about their business as consumers purchase from the Exchange directly and turn to Navigators, who do not require licensing, for assistance. Draft resolution: http://politi.co/8YCHfD

CHAMBER HAS 1099 SIGNATURES OBJECTING TO 1099 - The U.S. Chamber of Commerce releases today a letter to Congress in support of repealing the reform law’s 1099 provision, signed by 1,099 local chambers of commerce, associations and other businesses. The group’s chief concerns with the provision are the paperwork burden and an expected increase in accounting costs. They also say the move could hurt small businesses if companies choose to go with one large vendor instead of several smaller ones to reduce the reporting burden. The letter: http://politi.co/ddpfCr

VIRGINIA ANNOUNCES REFORM COUNCIL - The commonwealth’s AG may be suing to stop the reform law, but the governor Monday named the members of its Virginia Health Reform Initiative Advisory Council. The group will be responsible for developing a strategy for implementing the law and recommending “other innovative healthcare solutions” above and beyond the reform law. Dr. Bill Hazel, the state’s secretary of health and human resources, will lead the council.

ON THE CAMPAIGN TRAIL: REP. MICHAEL BURGESS, M.D. - The Texas doctor says the health reform law has dominated his recess. It came up enough during early August town halls that he scheduled three roundtable discussions, beginning today, with small businesses and doctors. “There is an overwhelming consensus in my district that the bill was an egregious mistake and we’d be correct to repeal it,” Burgess tells PULSE. “I would like to do that as well, but understand some of the difficulties. So this will be an opportunity to tell people what’s ahead in this election, what’s left to do in this Congressional year.” Burgess will broadcast his roundtables live here: http://bit.ly/9YmsG0

-- Despite opposing the reform law, Burgess still strongly encourages young adults to go into medicine. At an early August breakfast in D.C., he commended young medical fellows on their choice. “The future for the young doctor is limitless,” he says. “I’m not saying the federal bureaucracy won’t make your life miserable. But the ways to care for people, and tools you’ll have to alleviate pain, are going to be unlike anything anyone has ever seen.”

HHS RELEASES RATE REFORM GRANTS - The agency released $46 million in grants to 45 states and DC, “to give states additional resources to hold insurance companies accountable,” Sebelius told reporters Monday. The five states that did not apply: Alaska, Georgia, Iowa, Minnesota and Wyoming. Sebelius and OCIIO’s Jay Angoff plan to encourage those states to participate in rate review, but note HHS has authority to do it themselves as a fallback. “We would prefer this be done on the ground at the state level,” Sebelius said. “It’s not that the feds want to take [it] over.”

WHAT WE’RE READING:

--InformationWeek: “A new report concludes that EHRs will only be able to provide about a third of the data requirements for Stage 1 quality measures outlined in the final rule.” http://bit.ly/cSoPSd

--NYT: “The economic crisis in the United States has reduced the use of routine medical care, and the cutbacks here are much deeper than in countries with universal health care systems.” http://nyti.ms/bUtTbi

** A message from PhRMA: Diabetes is a complex disease affecting more than 30 million Americans – with one-in-ten living in DC, Maryland and Virginia having the disease. Thanks to advances in diabetes care, patients around the country are living longer, healthier lives. Take five-year-old Rhys for example [link to his I’m Not Average profile]. He was diagnosed with type 1 diabetes at 15-months-old, but today, he is a thriving young boy. This is due in large part to new and innovative medicines developed by researchers and scientists at America’s biopharmaceutical companies. Learn more about the medicines in development for diabetes here. **

Authors:

About The Author

Jennifer Haberkorn is a senior health care reporter for POLITICO Pro. She’s covered the Affordable Care Act since it was being debated in Congress in 2009. Since then, she has written about the law from Capitol Hill, the federal agencies, the courts and outside the Beltway.

Before arriving at POLITICO, Haberkorn covered Congress and local business news for The Washington Times. Her work has also appeared in Health Affairs and The New Republic.

Haberkorn is a graduate of Marquette University, where she majored in journalism and served as editor of The Marquette Tribune.

About The Author

Sarah Kliff is a health care reporter for POLITICO Pro. As a writer for POLITICO, she has covered how federal regulation, Congress and lobbying affect the implementation of health care reform. She previously co-authored Pulse, a daily health policy briefing.

Prior to joining POLITICO, Kliff was a staff writer at Newsweek, where she covered issues at the intersection of health and politics. She also covered the 2008 election, traveling with Joe Biden and contributing reports to multiple Newsweek cover stories. She has also written for National Geographic, St. Louis Magazine and Humanities magazine.

Kliff attended Washington University in St. Louis, where she was editor-in-chief of the campus newspaper, Student Life. She grew up in Seattle and Toronto, cities that have left her a big fan of the Toronto Maple Leafs and coffee.